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Implantable cardioverter defibrillator infection causing constrictive pericarditis
A H Kassanoff1, C B Levin, C R Wyndham
1Department of Medicine, Presbyterian Hospital of Dallas.
Chest
|September 1, 1992
Summary
An indolent Pseudomonas aeruginosa infection of an automatic internal cardiac defibrillator (AICD) led to severe constrictive pericarditis. Prompt removal of infected AICD components is crucial to prevent fatal complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Devices
Background:
- Indolent infections of implanted cardiac electronic devices can be challenging to diagnose and treat.
- Pseudomonas aeruginosa is a potential pathogen in device-related infections.
Observation:
- A case of severe constrictive pericarditis developed secondary to an undiagnosed Pseudomonas aeruginosa infection of an automatic internal cardiac defibrillator (AICD).
- Initial attempts to explant the AICD were complicated by dense adhesions, leading to a fatal outcome during a subsequent surgical intervention.
Findings:
- Infection of AICD components, even indolent ones, can progress to severe cardiac complications like constrictive pericarditis.
- Diagnostic challenges exist in identifying early-stage device infections.
- Complete removal of the entire AICD system (lead and generator) is recommended upon suspicion of infection.
Implications:
- This case highlights the critical importance of early detection and complete removal of infected AICD systems.
- Clinicians should maintain a high index of suspicion for device infection in patients presenting with unexplained cardiac symptoms.
- Improved diagnostic strategies for AICD infections are needed.